Healing With Computers

Doctors Are Proposing A Model Network Using Computer Technology To Reduce Errors Plaguing U.s. Health Care.

December 13, 2001|By JOHN A. MACDONALD; Courant Staff Writer

WASHINGTON — Your doctor has the weekend off, so the call goes to another physician in his practice, who is out to dinner.

It's the hospital where you are a patient calling with a question about a prescription drug you have been taking. The doctor who takes the call has never seen you but pulls a wallet-size device from his pocket, dials up your records and gives the hospital instructions.

That is the futuristic vision of a group that said Tuesday its members have formed a network that will use the latest in computer technology to reduce the number of medical errors plaguing the U.S. health care system.

``The network will enable providers to immediately access vital blocks of information from disparate sources, at any time and from any point of care, and will dramatically enhance patient safety and improve treatment,'' said Jack C. Lewin, chief executive of the California Medical Association and a board member of the new nonprofit group, the Patient Safety Network.

The plan comes two years after the National Academy of Sciences' Institute of Medicine reported that 44,000 to 98,000 people die each year in hospitals because of mistakes by medical professionals.

Medical groups have been trying to correct the problem, and a report published Tuesday in the Journal of the American Medical Asociation, JAMA, showed the problem goes beyond fatal errors in hospitals. About one in five elderly Americans receives at least one potentially inappropriate prescription drug, the report said. That study covered patients in hospitals, nursing homes, doctors' offices and at home.

Technology already exists that can help reduce such errors without compromising patient confidentiality, Lewin and other safety network members said. The challenge is to harness the technology, link different information systems and persuade doctors and hospitals that keeping records electronically has benefits.

Representatives of several physician, hospital and consumer groups said they are eager to participate. William F. Jessee said that nearly 20 percent of the 200,000 physician members of his Colorado-based medical management association already use some form of electronic records. Within a few years, Jessee predicted, patients will consider doctors out of date if they do not keep electronic records.

The key to whether hospitals and doctors will participate, one hospital association spokesman said, will be whether the system works. ``These kinds of experiments hold enormous potential to make the whole health care experience work,'' said Rick Wade of the American Hospital Association. But he noted the U.S. health care system is fragmented, making it difficult to pull information together in a central location.

Safety network officials said other groups had tried but failed to make similar systems work. But Dee Hock, the founder of VISA International and a pioneer in data transmission, was optimistic about the proposal. ``This is not new,'' Hock said. ``It's been done over and over again [in other areas]. It's just that health care is in the Dark Ages.''

With $8 million in hand from a half-dozen corporate sponsors, the network expects to test its system in the middle of next year and begin going nationwide in 2003, Lewin said. Initially, data will be available in five key areas: diagnoses, lab tests, medications, allergies and immunizations.

Daniel H. Winship, vice chancellor of health affairs at the University of Missouri Health System, estimated the system could cost as much as $27 million but it would reap $55 million in savings by reducing medical errors, inappropriate hospital admissions and other forms of unneeded treatment.

Reducing medical errors has become one of the health care industry's highest priorities since the publication of the Institute of Medicine report. Earlier this year, for example, the Joint Commission for the Accreditation of Healthcare Organizations published standards to prevent medical errors and to inform patients if they have been harmed during hospital treatment.

Meanwhile, insurers have been trying to introduce technology to collect and process claims data. And experts predict it will not be long before most health plan enrollment is done over the Internet. Humana, of Louisville, Ky., has announced it will soon bundle Internet insurance options to increase the number of choices employers can offer to workers.

The JAMA study said that people with poor health and more prescriptions have ``a significantly higher risk'' of inappropriate use of medications. Reducing the problem depends on changes in physician practices, patient education and a computerized reminder system, the report said.

Safety network officials said their system would help physicians avoid prescribing drugs or combinations of drugs that could be harmful, and provide a history of patients' allergies that would help reduce errors.